Prothrombinase-Induced Clotting Time to Measure Drug Concentrations of Rivaroxaban, Apixaban, and Edoxaban in Clinical Practice: A Cross-Sectional Study.

Details

Serval ID
serval:BIB_E303659E8D1E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Prothrombinase-Induced Clotting Time to Measure Drug Concentrations of Rivaroxaban, Apixaban, and Edoxaban in Clinical Practice: A Cross-Sectional Study.
Journal
Life
Author(s)
Sathanantham V., Alberio L., Bovet C., Fontana P., Gerber B., Graf L., Mendez A., Sauter T.C., Schmidt A., Studt J.D., Wuillemin W.A., Nagler M.
ISSN
2075-1729 (Print)
ISSN-L
2075-1729
Publication state
Published
Issued date
11/07/2022
Peer-reviewed
Oui
Volume
12
Number
7
Pages
1027
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Prothrombinase-induced clotting time (PiCT) is proposed as a rapid and inexpensive laboratory test to measure direct oral anticoagulant (DOAC) drug levels. In a prospective, multicenter cross-sectional study, including 851 patients, we aimed to study the accuracy of PiCT in determining rivaroxaban, apixaban, and edoxaban drug concentrations and assessed whether clinically relevant drug levels could be predicted correctly. Citrated plasma samples were collected, and the Pefakit <sup>®</sup> PiCT was utilized. Ultra-high performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) was performed to measure drug concentrations. Cut-off levels were established using receiver-operating characteristics curves. We calculated sensitivities and specificities with respect to clinically relevant drug concentrations. Spearman's correlation coefficient between PiCT and drug concentrations was 0.85 in the case of rivaroxaban (95% CI 0.82, 0.88), 0.66 for apixaban (95% CI 0.60, 0.71), and 0.78 for edoxaban (95% CI 0.65, 0.86). The sensitivity to detect clinically relevant drug concentrations was 85.1% in the case of 30 µg L <sup>-1</sup> (95% CI 82.0, 87.7; specificity 77.9; 72.1, 82.7), 85.7% in the case of 50 µg L <sup>-1</sup> (82.4, 88.4; specificity 77.3; 72.5, 81.5), and 85.1% in the case of 100 µg L <sup>-1</sup> (80.9, 88.4; specificity 73.2%; 69.1, 76.9). In conclusion, the association of PiCT with DOAC concentrations was fair, and the majority of clinically relevant drug concentrations were correctly predicted.
Keywords
apixaban, cross-sectional studies, diagnostic accuracy, direct oral anticoagulants, edoxaban, laboratory monitoring, prothrombinase-induced clotting time, rivaroxaban, sensitivity and specificity
Pubmed
Open Access
Yes
Create date
02/08/2022 12:27
Last modification date
11/11/2022 6:39
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